Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Swelling Above Right Testicle?
Question: I would like to know what the likely cause of scrotal swelling is. The details are as follows:
1. Swelling above right testicle in the soft tissue above the testicle/ head of the testicle
2. Swelling is most prominent when sitting or standing. Swelling disappears completely when lying down and was not identified on ultrasound when lying down.
3. Swelling feels like a singular swelling as opposed to several small swellings.
4. Swelling is accompanied by some pain and tenderness.
5. The swelling varies in size and can be the size of my thumb.
6. I do have varicoceles in the left scrotum, that feel like a bag of worms. However this feels different.
7. The swelling can feel thick and hard when at maximum swelling.
8. Sometimes the swelling disappears when I gently pull the testicle or stretch it away from the body.
9. I have had the pain for about two years now. It came on suddenly one morning. Initially diagnosed as epididymitis but I believe that it was a speculative diagnosis (I was examined when lying down). A sexual health practitioner believed that it may have been some form of cyst having felt the swelling (when standing). I neglected to mention to the practitioner that the swelling disappears when I lie down - which i am not sure normally applies to an epididymal cyst.
10. It almost feels like the head of the epididymis or the area around the head swells up when intra-abdominal pressure is increased.
1. Swelling above right testicle in the soft tissue above the testicle/ head of the testicle
2. Swelling is most prominent when sitting or standing. Swelling disappears completely when lying down and was not identified on ultrasound when lying down.
3. Swelling feels like a singular swelling as opposed to several small swellings.
4. Swelling is accompanied by some pain and tenderness.
5. The swelling varies in size and can be the size of my thumb.
6. I do have varicoceles in the left scrotum, that feel like a bag of worms. However this feels different.
7. The swelling can feel thick and hard when at maximum swelling.
8. Sometimes the swelling disappears when I gently pull the testicle or stretch it away from the body.
9. I have had the pain for about two years now. It came on suddenly one morning. Initially diagnosed as epididymitis but I believe that it was a speculative diagnosis (I was examined when lying down). A sexual health practitioner believed that it may have been some form of cyst having felt the swelling (when standing). I neglected to mention to the practitioner that the swelling disappears when I lie down - which i am not sure normally applies to an epididymal cyst.
10. It almost feels like the head of the epididymis or the area around the head swells up when intra-abdominal pressure is increased.
Brief Answer:
Possibility of spermatic cord hydrocele funicular type might be considered
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
From my experience and after having read through the nature of the swelling and the way it appears/ reduces, one of the conditions that comes to my mind is a funicular hydrocele - fluid collection that communicates with the peritoneum at the internal inguinal ring but does not communicate with the tunica vaginalis and is classified as one type of spermatic cord hydrocele.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Possibility of spermatic cord hydrocele funicular type might be considered
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
From my experience and after having read through the nature of the swelling and the way it appears/ reduces, one of the conditions that comes to my mind is a funicular hydrocele - fluid collection that communicates with the peritoneum at the internal inguinal ring but does not communicate with the tunica vaginalis and is classified as one type of spermatic cord hydrocele.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply, it has been helpful to me and you may well be correct in that it is a Funicular hydrocele.
I am assuming that the only treatment for this is surgery?
I am also assuming that most medical practitioners would advise against surgery given my age unless I am in enough pain to justify surgery?
Is a funicular hydrocele something to be concerned with?
How would one obtain a conclusive diagnosis that this is a funicular hydrocele? I note that ultrasounds are often performed whilst lying down and even when I stand up, the swelling does not always immediately appear - which makes it rather frustrating when attempting to demonstrate the swelling to a medical practitioner.
Thank you for your assistance.
I am assuming that the only treatment for this is surgery?
I am also assuming that most medical practitioners would advise against surgery given my age unless I am in enough pain to justify surgery?
Is a funicular hydrocele something to be concerned with?
How would one obtain a conclusive diagnosis that this is a funicular hydrocele? I note that ultrasounds are often performed whilst lying down and even when I stand up, the swelling does not always immediately appear - which makes it rather frustrating when attempting to demonstrate the swelling to a medical practitioner.
Thank you for your assistance.
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Usually this condition requires a surgical correction at the optimum time. It is an elective surgery which your doctor and you should be discussing and then proceeding with it.
Clinical examination is very important before considering a surgery and as mentioned above, it is not an emergency and therefore can be evaluated in detail and then done at an appropriate time. Pain and swelling are indicators of an early surgery.
A funicular hydrocele cannot be completely ignored if present. proper detailed ultrasound scan is required to pick up any more associated findings like a varicocele or hernia in that area. This is something that can wait and if there are associated conditions then the wait gets shorter. The only concern would be any erection or fertility related problem, which are quite important for any man.
Little effort has to be made when doing the scan. It will help to scan the area in lying down and standing position and then confirming it as a funicular hydrocele. Your frustration is understandable. You can take a picture of the swelling on y our phone camera when you think it is most prominent and share it during your next hospital visit. Please remember to share the image during the ultrasound scan so that they know what to search for.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Usually this condition requires a surgical correction at the optimum time. It is an elective surgery which your doctor and you should be discussing and then proceeding with it.
Clinical examination is very important before considering a surgery and as mentioned above, it is not an emergency and therefore can be evaluated in detail and then done at an appropriate time. Pain and swelling are indicators of an early surgery.
A funicular hydrocele cannot be completely ignored if present. proper detailed ultrasound scan is required to pick up any more associated findings like a varicocele or hernia in that area. This is something that can wait and if there are associated conditions then the wait gets shorter. The only concern would be any erection or fertility related problem, which are quite important for any man.
Little effort has to be made when doing the scan. It will help to scan the area in lying down and standing position and then confirming it as a funicular hydrocele. Your frustration is understandable. You can take a picture of the swelling on y our phone camera when you think it is most prominent and share it during your next hospital visit. Please remember to share the image during the ultrasound scan so that they know what to search for.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
